Age, symptoms and upper gastrointestinal malignancy in primary care endoscopy.
OBJECTIVE
Upper gastrointestinal complaints are common in the general population. The aim of this study was to establish whether age and occurrence of alarm symptoms are predictors of malignancy in primary care open-access endoscopy.


METHODS
The material comprised 10,061 consecutive patients referred for gastroscopy by general practitioners from 1989 to 2000. The presenting symptoms were recorded; alarm symptoms comprised dysphagia, weight loss, gastrointestinal bleeding, anaemia and vomiting.


RESULTS
In all, 13.0% (1310) of the patients had alarm symptoms. Malignancy was detected in 0.7% (72 patients) in the whole series, in 0.3% (13 patients) aged 55 years or younger and in 1.1% (59 patients) over 55 years of age; the respective percentages in patients with alarm symptoms were 2.5% (33 patients), 1.0% (5 patients) and 3.4% (28 patients). Alarm symptoms (odds ratios 3.98; confidence interval 2.47-6.41), age (1.07/year; 1.05-1.09) and male gender (1.95; 1.22-3.12) were significantly associated with gastrointestinal malignancy.


CONCLUSIONS
The total number of malignancies in the primary care open-access gastroscopy series was low. Alarm symptoms increased the risk 5-6-fold; such patients should therefore undergo endoscopy without delay. At a further one year of age the risk was increased by 7%, but no definite age limit for endoscopy could be asserted.
Salo
Maarit
M
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
Collin
Pekka
P
Kyrönpalo
Sinikka
S
Rasmussen
Martin
M
Huhtala
Heini
H
Kaukinen
Katri
K
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology; D002648:Child; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000175:diagnosis*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D014839:Vomiting / Q000209:etiology; D015431:Weight Loss